This project is a partnership between environmental researchers at the University of Pennsylvania, local health care providers at Health South Hospital, Parkersburg WV, and the -Decatur Community Association, to address exposure of residents in the Little Hocking Water Association district (LHWAD) to C8. Little Hocking is a village in the Appalachian region near Parkersburg WV, located directly across the Ohio River and downwind of a plant with significant discharges of C8 to air, ground, and water. Residents of LHWAD have known exposures to C8 through air, residential drinking water domestic well water, and community water; some residents have occupational exposure (with possible domestic household contamination). There are other potential exposure sources. C8 is known to be very persistent in both the environment and in humans (serum half-life approximately 4 years). C8 can be toxic to the liver, causes testicular cancer and mammary hyperplasia and may have reproductive effects in experimental animals. Human data is limited but adverse effects have been reported from occupational exposure. Events surrounding C8 contamination in Little Hocking and surrounding areas have led to substantial community skepticism and lack of trust. Through this project the partners will measure C8 in a stratified sample of residents and identify the relative importance of the various potential exposure sources. To help assess C8 risk levels in residents will be compared with those in other population and occupational groups and by determining if early biomarkers of toxic effect are associated with higher C8 levels. This information will be shared with the community, and an implementation plan developed to reduce exposures. A community participation model will be used to involve stakeholders at all stages. Two-way communication, and education of community residents and local health practitioners will be emphasized. The effectiveness of communication and education and the level of participation of residents will be evaluated. Outcome measures to be evaluated include the reduction of levels of blood C8, and whether community trust is restored through an independent participatory study.